目的 本研究旨在通过回顾性分析，寻找影响腹膜透析患者腹膜溶质转运速率(peritoneal solute transport rate，PSTR)增快的影响因素。方法 研究对象为2017年6月～2022年6月在北京大学人民医院进行腹膜透析治疗且做过2次腹膜平衡试验的成年(年龄≥18岁)终末期肾病患者。按2次PSTR的变化分为PSTR增快组和PSTR减慢组，比较2组患者的人口学资料、透析方案、用药、实验室指标的差异。使用Logistic回归(输入法)筛选与PSTR增加相关的独立影响因素。 结果 共入选80例腹膜透析患者。其中，PSTR增快组48人(60%)；PSTR减慢组32人(40%)。PSTR增快组与PSTR减慢组相比：透析龄更长(Z =-2.642，P=0.008)，基线PSTR更低(t=-3.215，P =0.002)、采用持续腹膜透析模式的比例更高(χ2=3.879，P=0.049)。Logistic回归分析提示透析龄(OR =0.975，95% CI：0.959～0.991，P =0.002)、基线PSTR(OR =21 455.039，95% CI：43.218～10 651 164.48，P =0.002)对PSTR增加有独立的影响，是否持续透析(OR=2.442，95% CI：0.734～8.130，P =0.146)不是PSTR增加的独立危险因素。 结论 长透析龄、低PSTR、采用持续腹膜透析模式的患者更容易出现PSTR的增长。但是，持续腹膜透析模式不是PSTR增长的独立危险因素。
Objective The purpose of this study was to find out the independent factors influencing the increase of peritoneal solute transport rate (PSTR) in peritoneal dialysis (PD) patients by retrospective analysis. Methods The PD patients were the adults (≥18 years old) with end-stage renal disease who had undergone PD in Peking University People's Hospital and had subjected to two peritoneal balance tests from June 2017 to June 2022. According to the changes of PSTR, the patients were divided into two groups: PSTR ascending group and PSTR descending group. Independent sample T test, rank sum test or chi square test was used to compare the differences in demographic data, dialysis program, medication and laboratory indicators between the two groups. Logistic regression (input method) was used to detect the independent risk factors relating to the increase of PSTR. Results This study enrolled a total of 80 PD patients, of which 48 (60%) were in the PSTR ascending group and 32 (40%) in the PSTR descending group. The PSTR ascending group had the characteristics of longer dialysis age (Z=-2.642, P=0.008), lower baseline PSTR (t=-3.215, P=0.002), and higher proportion of patients using continuous PD (χ2=3.879, P=0.049), as compared those in the PSTR descending group. Logistic regression showed that dialysis age (OR=0.975, 95% CI 0.959~0.991, P=0.002) and baseline PSTR (OR=21 455.039, 95% CI 43.218~10 651 164.480, P=0.002) had the independent effects on the increase of PSTR, and that whether continuous PD was used or not (OR=2.442, 95% CI 0.734~8.130, P=0.146) was not an independent risk factor for the increase of PSTR. Conclusion Patients with longer dialysis age, lower baseline PSTR and continuous PD mode are more likely to have increased PSTR. However, continuous PD mode is not an independent risk factor for the increase of PSTR.
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